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Fatal overdoses associated with quetiapine.
Loralie J Langman1, Henry A Kaliciak, Sheila Carlyle
1Provincial Toxicology Centre, Riverview Hospital, Coquitlam, British Columbia V3C 4J2, Canada. llangman@bcmhs.bc.ca
Journal of Analytical Toxicology
|November 2, 2004
Summary
Three cases of suicidal overdose deaths were linked to quetiapine (Seroquel). Blood quetiapine concentrations were significantly higher than therapeutic ranges, indicating its role in fatalities.
Area of Science:
- Forensic Toxicology
- Pharmacology
- Clinical Chemistry
Background:
- Quetiapine (Seroquel), an atypical antipsychotic, is a benzothiazepine derivative.
- This study investigates three fatal overdose cases involving quetiapine.
Observation:
- Suicidal overdose deaths associated with quetiapine were analyzed.
- Toxicological analysis included GC-NPD, GC-MS, and HPLC-DAD for drug screening.
- Quetiapine was specifically assayed in biological specimens.
Findings:
- Quetiapine concentrations in fatal cases were 6-16 times above the upper therapeutic range (0.1-1.0 mg/L).
- Case 1: Blood quetiapine 7.20 mg/L; Case 2: Blood quetiapine 16 mg/L; Case 3: Femoral blood quetiapine 5.90 mg/L.
- In Cases 1 and 2, quetiapine was the primary cause of death; Case 3 was a mixed drug overdose.
Implications:
- High quetiapine concentrations can be lethal, even in the absence of other contributing substances.
- This highlights the importance of considering quetiapine in overdose investigations.
- Accurate toxicological quantification of quetiapine is crucial for determining cause of death.